Nutritional Essay To Improve Cardiovascular Disease Pathophysiology.

To provide a comprehensive overview of an applied human nutrition research topic Task

This assignment will aim at addressing the following question:

“What nutritional strategies should be used to improve cardiovascular disease pathophysiology”?

Write an essay reviewing the current scientific literature and pitched to a scientifically literate audience (a fellow science student). The purpose of the work is to apply biochemistry and physiology knowledge to a real-life situation.

The assignment should contain:

1. 1)  A general introduction about the cardiovascular system, its structure, function and physiology. The introduction should present a basic but thorough understanding of the system that will be studied and its importance to regulating bodily health i.e. CVD. This information should be drawn from the lectures and from the scientific literature (mostly textbooks and reviews)
2. 2)  A specific background section about what cardiovascular disease is and how it is caused. This section should include nutritional and non-nutritional aspects i.e. physical activity or genetics. What is the pathophysiology of cardiovascular disease (What are the symptoms/effects on the body) for example atherosclerosis? What are the outcomes? This information should be drawn from the scientific literature (mostly reviews and original research papers)
3. 3)  A review of the scientific literature about the role of nutrition in the maintenance of cardiovascular disease pathophysiology. Special consideration should be given to:

• The involvement of dietary fats (lipids) in the molecular mechanisms of CVD.
• What types of dietary fats should be used and avoided and describe why based on their molecular/chemical structure?
• Where the dietary fat sources should be derived from in comparison to sources that should be avoided and why – based on the different fat types present in the sources?
• Other nutritional considerations, for example what other nutrients could a person with CVD ingest, that would have a positive effect to counter CVD pathophysiology.

This information should be drawn from the scientific literature (mostly original research papers) You may use some lecture material regarding the macronutrient and chemical structures.

4) A short conclusion summarizing your findings, with a clear take home message but no new information or views

Overview of the cardiovascular system and its role in maintaining bodily homeostasis

The cardiovascular system or the circulatory system of the human body is responsible for the circulation of the body fluids mainly the blood in the different parts of the body and it is stated that the system is important for the maintenance of the bodily homeostasis. Therefore, it is stated that this cardiovascular system is mainly composed of heart, blood vessels that are mainly arteries, vein and capillaries. The circulation of bloods in the different parts of the body is associated with the supply of adequate amount of oxygen to those organs as the blood contains haemoglobin that has the capability to bind with the oxygen molecule and thereby the oxygen is delivered to the respective organs. The crucial role of the cardiovascular system in the maintenance of the homeostasis is dependent on the constant and organized movement of blood through the capillaries that pervade every cell and tissues for supplying the oxygen and along with this, the essential materials along with the nutrient products are also supplied to the cells by the blood. Moreover, various control measures are also involved in the control and delivery of the blood to the various capillaries of the body as per the demand of the bodily system (1).

Heart is a crucial part of the cardiovascular system and it is associated with the pumping of blood in different parts of the body. In normal condition, a heart can pump almost 5 litres of blood every minute. There are four chambers in the heart and for the pumping process of the heart the myocardium plays the key role. The conduction system (SA node and AV node mainly) of the heart is responsible for the cardiac cycle that is systole and diastole of the cardiac system (1).

While discussing about the cardiovascular disease, it can be stated that there are different types of cardiovascular diseases and any type of problem related to the heart and the blood vessels can cause serious health problems. Therefore, most of the cardiovascular diseases are related to the formation of the plaques in the blood vessels and thereby called atherosclerosis (2). As per the information of the World Health Organization, it is stated that the most common cardiovascular diseases are mainly the coronary heart disease, peripheral arterial disease, cerebrovascular disease, rheumatic heart disease, deep vein thrombosis and pulmonary embolism and congenital heart disease (3). Moreover, there are another two cardiovascular problems and they are mainly the strokes and heart attacks which are mainly associated with the blockage in the blood vessels. While discussing about the various reasons of the cardiovascular disease, it can be stated that the heart diseases can be transmitted from one generation to another generation and it is reported that just one or a few changes in the genes are responsible for the transmission of the cardiovascular diseases. However, most of the coronary artery diseases are polygenic that is such diseases require changes in a number of genes to occur the disease (4). Therefore, it is observed that the regular performances of the physical exercises can prevent the onset or development of the cardiovascular disease. More specifically physical activity can prevent the onset of the coronary heart diseases (5). Hence, it can be stated that the practice of the physical activity can prevent these diseases. Formation of the plaques in the vessel walls prevents the blood to flow into the heart properly and thereby the heart fails to supply blood in different organs properly. Moreover, formation of plaques is mainly due to the lack of physical activities and poor dietary practices as the plaques are mainly composed of lipids and fatty acids. As a consequence, chest pain, stroke, angina may take place (6).

Different types of cardiovascular diseases

While discussing about the role of nutrients in the progress of the cardiovascular disease, it can be stated that the role of dietary fat intake in the development of the disease is very crucial and the consumption of fat enriched foods is directly related with the growth of the disease. It is well recognized that the consumption of the saturated fatty acids (SFA) enhance the amount of low-density lipoprotein (LDL) cholesterol in the body and it is considered as a strong threat for CVD. The main association in between the onset of the cardiovascular disease and the consumption of the dietary fats is the structures of the dietary fats that can alter the transport, absorption and even destination of the fat molecules. In this regard, it can be stated that the Medium chain fatty acids (MCFA) comprise 7–12 saturated carbons and on the other hand, short chain fatty acids comprise 1-6 saturated carbons. In case of the Long chain fatty acids (LCFA), the number of saturated carbons is 13 or more and these structural differences are associated with the differences in the absorption (7). On the contrary, a recent study comprised of the NHS and Health Professionals Follow-Up Study (HPFS) showed that the consumption of the longer chain SFA (12:0–18:0) can also enhance the threat of CVD (8).

The most common causes of the saturated LCFA are palmitic acid (16:0), myristic acid (14:0) and stearic acid (18:0). The foods that are considered to be the source of the myristic acid are palm kernel oil, butter and coconut oil. On the other hand, the dietary sources of palmitic acid are palm kernel oil, sunflower oils, meats, soybean, dairy fat, and cocoa butter. Therefore, it is reported that that the myristic and palmitic acids have serious impact on the cholesterol level of the body and thereby the risk of the development of CVD in the individuals are enhanced. Moreover, cheese contains almost 16.5 per cent of SFA and milk contains almost 8.3 per cent of the SFA (7). The deposition of the fat particles and lipids are associated with the onset of the lipotoxicity that is considered to be a primary risk factor for the growth of the cardiovascular diseases including atherosclerosis, hypertension and coronary heart disease. The consumption of the dietary fats is associated with the obesity and thus the enhancement of the circulating lipids takes place. As a consequence of this, the generation of the toxic ingredients in the body of the individuals is increased as well. The incidences of the lipotoxicity refer to the condition in which abnormal lipid accumulation takes place and eventually causes the cellular dysfunction and necrosis. In this regard, it can be stated that the lipid overload in the body is associated with the onset of the apoptotic cascade (9). Therefore, replacement of the SFA with the MUFA can also reduce the chances of the development of CVD among the individuals. In a recent study, it was reported that the consumptions of the trans -fatty acids (TFA) and SFA can promote the onset of the disease and on the contrary, the n-3 PUFA, n-6 PUFA, or MUFA consumption in place of SFA or TFA can improve the condition of cardiovascular diseases by reducing the chances of disease development. The latest study showed the protective effects of the MUFA when consumed along with the essential fatty acids such as docosahexaenoic acid. The study also stated that the MUFA is also associated with the regulation of the fat oxidation, appetite sensations, energy metabolism, maintenance of body weight and metabolism of cholesterol. Therefore, it can be stated that these favourable effects of MUFA makes it a preferable choice to substitute for other fatty acids (10). In order to make the heart healthy and safe from the development of the cardiovascular diseases, one individual should avoid processed meats, refined and processed carbohydrates and grains, soft drinks and sugary drinks. Furthermore, the individual should consume avocado, nuts, olive oil (11, 12,13).

Genetic and lifestyle factors that contribute to the onset of cardiovascular diseases

Apart from this one individual suffering from any type of the cardiovascular diseases should consume leafy green vegetables such as kale, spinach and collard greens, whole grains including barley, buckwheat, whole wheat, oats, brown rice, rye, and quinoa, different types of berries such as blackberries, strawberries, blueberries and raspberries, walnuts, beans and dark chocolate. All of these foods are filled with fibres, vitamins, antioxidants that may help in the improvement of the cardiovascular condition of the patients (14).

Conclusions

Hence, it can be concluded that the cardiovascular health is highly dependent on the dietary practices of the individuals. The blood present in the circulatory system is pumped by the heart in the different parts of the body and thus the bodily balance is maintained as well. The cardiovascular system plays a vital role in the maintenance of the bodily homeostasis. The heart diseases can be transmitted from one generation to another generation and it is reported that just one or a few changes in the genes are responsible for the transmission of the cardiovascular diseases. Most of the studies examining the role of the dietary fat intake and onset of the cardiovascular disease stated that the risk is mainly associated with the consumption of the medium and short chain fatty acids. Consumption of the MUFA can also reduce the chances of the development of CVD among the individuals.

References

Aaronson PI, Ward JP, Connolly MJ. The cardiovascular system at a glance. John Wiley & Sons; 2020 Feb 25.

Rosenson RS, Brewer Jr HB, Ansell BJ, Barter P, Chapman MJ, Heinecke JW, Kontush A, Tall AR, Webb NR. Dysfunctional HDL and atherosclerotic cardiovascular disease. Nature reviews cardiology. 2016 Jan;13(1):48.

World Health Organization. Cardiovascular diseases (CVDs). 2020. Retrieved from- https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR, Chasman DI, Baber U, Mehran R, Rader DJ, Fuster V. Genetic risk, adherence to a healthy lifestyle, and coronary disease. New England Journal of Medicine. 2016 Dec 15;375(24):2349-58.

Varghese T, Schultz WM, McCue AA, Lambert CT, Sandesara PB, Eapen DJ, Gordon NF, Franklin BA, Sperling LS. Physical activity in the prevention of coronary heart disease: implications for the clinician. Heart. 2016 Jun 15;102(12):904-9.

Borén J, Chapman MJ, Krauss RM, Packard CJ, Bentzon JF, Binder CJ, Daemen MJ, Demer LL, Hegele RA, Nicholls SJ, Nordestgaard BG. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. European Heart Journal. 2020 Feb 13.

Briggs MA, Petersen KS, Kris-Etherton PM. Saturated fatty acids and cardiovascular disease: replacements for saturated fat to reduce cardiovascular risk. InHealthcare 2017 Jun (Vol. 5, No. 2, p. 29). Multidisciplinary Digital Publishing Institute.

Zong G, Li Y, Wanders AJ, Alssema M, Zock PL, Willett WC, Hu FB, Sun Q. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. Bmj. 2016 Nov 23;355:i5796.

Manandhar S, Ju S, Choi DH, Song H. Lipid-induced cardiovascular diseases. J Cardiol Cardiovasc Med. 2017; 2: 085-094.

Hammad S, Pu S, Jones PJ. Current evidence supporting the link between dietary fatty acids and cardiovascular disease. Lipids. 2016 May 1;51(5):507-17.

Weschenfelder C, dos Santos JL, de Souza PA, de Campos VP, Marcadenti A. Avocado and cardiovascular health. Open Journal of Endocrine and Metabolic Diseases. 2015;5(07):77.

Bitok E, Sabaté J. Nuts and cardiovascular disease. Progress in cardiovascular diseases. 2018 May 1;61(1):33-7.

Covas MI, de la Torre R, Fitó M. Virgin olive oil: a key food for cardiovascular risk protection. British Journal of Nutrition. 2015 Apr;113(S2):S19-28.

Link R. 15 Incredibly Heart-Healthy Foods. Healthline.com. 2018. Retrieved from- https://www.healthline.com/nutrition/heart-healthy-foods